سياسات الشراكة
شراكة كاليفورنيا للرعاية طويلة الأجل
كيف أحصل على وثيقة الشراكة؟
يجب أن تتمتع جميع البوالص المعتمدة من الشراكة بحماية معينة لضمان حصولك على بوليصة تأمين عالية الجودة تلبي احتياجاتك. وتشمل هذه:
- Inflation Protection – This protects the policyholder from covering the difference between what the insurance policy will pay, which is based on the costs of services when you purchased the policy and the actual cost of care when you need it. Every Partnership policy is required to have this protection, and the state highly recommends that you protect yourself by only purchasing a policy with inflation protection.
- حماية الأصول
- Comprehensive Care Management – A process to assess, plan, coordinate, and monitor long-term care needs and services. Care management/care coordination takes an all-inclusive look at a person’s total needs and resources, and links that person to a full range of appropriate services, using all available funding (and informal) sources.
- Rate Increases Regulated by the California Partnership for Long-Term Care – Long Term Care is the care given to someone who can no longer perform activities of daily living.
Partnership policies have two unique features that make them especially attractive.
Care Management: The Partnership requires that a Care Management Provider Agency, approved by the State Department of Health Care Services and independent from the insurer, provide care coordination for Partnership policyholders.
Using a collaborative process, the care manager works with the policyholder, their family, and physician to complete a comprehensive assessment to determine the client’s needs and resources, and develop a detailed Plan of Care individualized to meet those needs.
- Plan of Care: In developing the plan of care, the care coordinator will consider the unique needs of the client and recommend alternatives for how those needs can best be met. It is likely that without the help of a care coordinator, a policyholder or their family would have no idea of where to find someone to provide the necessary care. Partnership regulations require the care coordinator to consider how the policy benefits can help meet the policyholder’s needs and how the needs might also be met through other sources, perhaps through community services or the client’s health coverage, etc. These other sources can help reduce the out-of-pocket expenses to the policyholder as well as help the policy benefits last as long as possible. The identification of other sources of care can be especially important for a person who has a policy designed to pay benefits for only one or two years. Furthermore, since the Partnership requires the care coordinator to live in and be familiar with the community in which the policyholder resides, he or she will have a good understanding of where the quality providers are.
- تنفيذ الرعاية ومراقبتها: بالإضافة إلى إكمال التقييم الشامل وخطة الرعاية، يمكن لمنسق الرعاية أيضًا الاتصال بمقدمي الرعاية والترتيب لتواجدهم في المنزل لتقديم الرعاية في الأوقات المطلوبة، والتفاوض على معدلات الدفع ومراقبة جودة الخدمات المقدمة، إذا رغب حامل الوثيقة في ذلك.
Lifetime Asset Protection: This feature assures that catastrophic long-term care expenses won’t reduce you to poverty even if you run out of insurance benefits. That’s something other long-term care insurance policies do not offer (long-term care policies are a specific type of insurance policy designed to offer financial support to pay for necessary long-term care services.)
Here is how this special feature works. When you need care, your Partnership-approved private long-term care insurance policy pays for your care in the same way other high-quality long-term care policies would, but unlike a traditional non-Partnership policy, each dollar your Partnership policy pays out in benefits entitles you to keep a dollar of your assets if you ever need to apply for Medi-Cal services.
For most of you, the benefits of a Partnership insurance policy will provide all the care you will ever need. But you won’t have to impoverish yourself if you run out of insurance benefits and still need care. You can apply to Medi-Cal for assistance in paying the costs of your continued care and not have to “spend down” your savings to the poverty level. Each dollar your Partnership policy pays in benefits for your care is protected against Medi-Cal “spend down” rules. You may have to apply a portion of your income toward the cost of your care, but the assets you protected by purchasing a Partnership policy remain yours, for you and your spouse’s use or to leave to loved ones.
ما هي تكلفة بوليصة الشراكة؟
A Partnership policy costs about the same or slightly less than other policies that offer similar coverage. Each insurance company offering Partnership policies has its own premium rates. However, the younger you are when you purchase coverage, the less expensive your premium will be. That is a good reason to buy earlier.
Unlike other policies, Partnership policies include lifetime asset protection and access to Medi-Cal services should you ever need them – an invaluable added benefit at no extra cost. This added protection and peace of mind comes only with the purchase of a Partnership policy.
Because of the Partnership’s asset protection feature, you don’t have to worry that you may run out of insurance benefits and end up spending the savings that you hoped to protect by having to pay for ongoing care needs. The asset protection feature allows you to purchase policies with coverage equal to the amount of assets you want to protect, from approximately $47,000 up to your total assets, with the assurance that these assets are protected for life, no matter how extended or expensive your long-term care needs may be. Without a Partnership policy, you could only achieve lifetime asset protection by purchasing lifetime insurance coverage – something most people cannot afford.
كيف يمكنني الحصول على تغطية الشراكة؟
Partnership long-term care insurance policies may only be sold by select insurance companies that meet the special standards established by the state. Here is a list of Partnership certified companies.
لا يتم تسويق وثائق تأمين الرعاية طويلة الأجل للشراكة إلا من قبل متخصصي التأمين المرخصين الذين أكملوا التدريب الخاص الذي تتطلبه ولاية كاليفورنيا. تضمن لك بوليصة الشراكة، مع ميزة حماية الأصول الفريدة من نوعها مدى الحياة، أنك لن تضطر إلى إنفاق كل ما عملت من أجله على الرعاية طويلة الأجل.
التخلص من العمل التخميني من سياسة عالية الجودة
هناك نوعان من سياسات الشراكة المتاحة:
- سياسة المنشأة فقط التي تغطي الرعاية في المنشأة (دار رعاية المسنين ومرافق الرعاية السكنية) أو
- بوليصة شاملة تغطي الرعاية في المنزل وفي المجتمع وكذلك في دار رعاية المسنين ومرفق الرعاية السكنية.
أنت تختار مقدار التغطية التي تريدها. تقدم البوالص تغطية من سنة إلى خمس سنوات أو مدى الحياة. لكي تطمئن إلى أنك تختار تغطية عالية الجودة، تتضمن جميع وثائق الشراكة ما يلي
- حماية تلقائية من التضخم لضمان مواكبة مزاياك لارتفاع تكلفة الرعاية;
- خصم يجب الوفاء به مرة واحدة فقط في حياتك;
- تنسيق الرعاية لمساعدتك في تخطيط وتأمين الخدمات التي تريدها وتحتاجها;
- الإعفاء من الأقساط أثناء تلقيك الرعاية في دار رعاية المسنين أو مرفق الرعاية السكنية؛ و
- مزايا البوليصة القابلة للتبديل بحيث يمكن تخصيص الرعاية لتلبية احتياجاتك الفردية.